Association between premorbid neuropsychological conditions and pediatric mild traumatic brain injury/concussion recovery time and symptom severity: a systematic review
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
OBJECTIVE: The objective of this review was to identify associations between premorbid neuropsychological conditions and pediatric mild traumatic brain injury/concussion recovery time and symptom severity. INTRODUCTION: There is a lack of evidence-based clinical guidelines for the care of children with a premorbid neuropsychological condition who have sustained a mild traumatic brain injury, also known as concussion. This necessitates inquiry for any associations that may exist, which may contribute to an enhanced understanding of injury recovery patterns. INCLUSION CRITERIA: Participants included children ages six through 18 years with any diagnosed or self-reported premorbid neuropsychological condition(s) and mild traumatic brain injury/concussion. Participants with concomitant intracranial or extra-axial head injury found on diagnostic imaging were excluded. Outcomes for this review included recovery time or symptom(s) severity post-concussion. Studies considered for review were analytical observational studies, including retrospective, prospective, cross-sectional or longitudinal cohort studies or case-control studies, as well as descriptive observational study designs, including case series, individual case reports and descriptive cross-sectional studies. METHODS: A comprehensive search was undertaken in January 2018 for both published and unpublished studies utilizing an a priori protocol. Major databases searched included CINAHL, Embase, PubMed, Psychology and Behavioral Sciences Collection and PsycINFO. Other sources searched for unpublished and gray literature included the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Google Scholar, ProQuest Dissertations and Theses Global: Sciences and Engineering Collection and MedNar. Additional searches of government websites and reports targeting healthcare or sports-related concussions included Australian Sports Commission, Canadian Institutes for Health Research, the National Health Service of the United Kingdom, the U.S. Department of Health and Human Services: Agency for Healthcare Research and Quality, and the U.S. Department of Health and Human Services: Centers for Disease Control and Prevention. Critical appraisal and data extraction were completed by two independent reviewers. Validation of methodologic quality was performed utilizing standardized tools from the Joanna Briggs Institute, and any disputes were resolved through discussion. Due to significant heterogeneity among studies, a meta-analysis could not be conducted. Therefore, extracted data are reported in a narrative synthesis. RESULTS: A total of 12 studies (one analytical cross-sectional, two case-control and nine cohort) with 2,973 participants met inclusion criteria. Results of the findings among premorbid conditions varied. However, statistically significant associations with prolonged recovery or increased symptom severity were identified in children with pre-concussion histories of learning disabilities or poor academic achievement; anxiety, depression, mood disorders or other psychiatric illnesses; prior head injuries; somatization (in females); sleep disorders (in males); and the presence of multiple neuropsychological conditions. CONCLUSIONS: Due to heterogeneity among studies and limitations of the review, findings suggest that clinicians providing post-concussive care may consider the presence of premorbid neuropsychological conditions, specifically learning disabilities or poor academic achievement; anxiety, depression, mood disorders or other psychiatric illnesses; prior head injuries; somatization; sleep disorders; or the presence of multiple neuropsychological conditions as potential contributors to prolonged recovery times or increased symptom severity in children and adolescents with mild traumatic brain injuries.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.008 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it